Impaired Long-Term Graft Patency of Skeletonized versus Pedicled Left Internal Thoracic Artery Bypass

Background: Despite numerous advantages of skeletonized left internal thoracic artery grafts, latest research shows adverse patency rates and clinical outcome of skeletonized versus pedicled left internal thoracic artery harvesting after coronary artery bypass grafting.

Method: Long-term patency rates of left internal thoracic artery of 1,579 patients requiring re-angiography after isolated first-time coronary artery bypass grafting are evaluated regarding harvesting technique (skeletonized versus pedicled). Kaplan–Meier curves and multivariate Cox-regression analysis have been constructed.

Results: Kaplan–Meier curve shows impaired long-term patency rates for skeletonized versus pedicled harvesting technique of left internal thoracic artery (log-rank: p < 0.001). In multivariate Cox-regression analysis, skeletonized harvesting technique of left internal thoracic artery is an independent risk factor for dismal long-term graft patency status of left internal thoracic artery (p = 0.005).

Conclusion: Harvesting technique of left internal thoracic artery has an impact on long-term graft patency rates. Skeletonized harvesting technique is associated with worse long-term graft patency rates compared with pedicled harvesting technique.

Publication History

Article published online:
28 January 2023